NDS Neurodynamic Solutions

31/08/2026

💥💥💥LUMBAR NERVE ROOT 5 - It IS Neurodynamic!

Here is one of the most commonly confused parts of neurodynamic testing.

The previous video (Lumbar Nerve Root 4) demonstrated a MUSCULOSKELETAL RESPONSE. This means that the patient response did NOT change with the differentiating movements.

This can occur if not enough force is produced, but it CAN BE NORMAL.

NEURODYNAMIC RESPONSE - Here is an example of the response differentiating with ankle and/or neck movement in which the RESPONSE CHANGES.

WHAT DOES A CHANGE MEAN? It means that there was enough force on the neural tissues to evoke a response.

EXAMPLE - This is an example of a normal neurodynamic response, even though it differentiates.

People often think a POSITIVE TEST CHANGES and NEGATIVE TEST DOESN’T. This is NOT TRUE.

NEXT STEP - If it changes, the next step is to ascertain if if is normal or abnormal which is done later in the test evaluation.

25/08/2026

The LOWER QUARTER course in CALGARY is coming up!
- In-person - October 3-4
- Online - opens on Sept 3 (3 months).

LEARN how to diagnose and treat neural disorders in the mid-lumbar, lumbosacral, deep gluteal, hip knee and foot areas.
Early bird discount ends in 48 hours.

REGISTER NOW AND SAVE:

Instructor and Content In-Person Instructor: Dr Michael Maxwell, DC NDS courses are based on Michael Shacklock's best-selling text, Clinical Neurodynamics, have been taught to more than 11k clinicians worldwide and are considered foundational for many in the musculoskeletal field. Michael Shacklock....

16/08/2026

💥💥💥 LUMBAR NERVE ROOT 3. AVOID FALSE NEGATIVES

The previous post was how to avoid false positives; this one is how avoid FALSE NEGATIVES.

NORMAL SLUMP TEST IS NOT ALWAYS ACCURATE - Sometimes the slump test doesn’t give a true diagnosis of a neurodynamic part to the problem because of sensitivity and specificity.

SENSITIVITY - A sensitive test is abnormal in the presence of the problem.

SPECIFICITY - A specific tests is normal in the absence of the problem.

FALSE NEGATIVE - A false negative occurs when the test is normal but there IS A NEURODYNAMIC PROBLEM.

WHY WOULD THE SLUMP TEST PRODUCE A FALSE NEGATIVE? There are many reasons, but one is that you build the right sensitivity into your technique.

This can be caused by only doing the standard slump test in someone whose function is quite good - the test doesn’t produce enough nerve root movement to evaluate the patient’s neurodynamic full function.

So the test is normal when a small neurodynamic problem remains undetected.

HOW TO IMPROVE SENSITIVITY - You can improve your sensitivity by being sure to move the nerve root enough to touch on a small problem.

This is the 3a Slump Test in which we teach the subtleties that are needed for optimum sensitivity.

BUT - This is for the NEURAL TENSION DYSFUNCTION, not necessarily the SLIDING DYSFUNCTION. We test that differently.

09/08/2026

💥💥💥 LUMBAR NERVE ROOT - 2 - AVOID FALSE POSITIVES.

We cover this and more on the NDS Lower Quarter course (see below).

FALSE POSITIVE - False positives can make life harder because you can end up treating the neural aspect when it might not exist. So preventing false positives does two things: makes diagnosis accurate and you do less neural treatment which is easier.

EXTRANEOUS MOVEMENTS - These are movements that SHOULD NOT HAPPEN because they will contaminate diagnosis by reducing specificity.

KEY MOVEMENTS TO CONTROL - Two of the most common extraneous movements for the lumbar nerve root are:

1. Compression up the limb to the pelvis and lumbar spine - if this produces local movement, the diagnosis could be wrong because it will make us think there is a neural aspect when there might not be one.

2. Knee flexion a small amount - this changes hamstring tension and loses control of the pelvis.

Either of these extraneous movements could lead you to treat the nerve root when it may not be justified.

HOW TO AVOID A FALSE POSITIVE - The key is USE THE TIBIA to control the movement instead of the quadriceps.

Watch this video.

Next courses:

LOWER QUARTER - Hybrid Courses

CHICAGO/SCHEREVILLE, IN
October 10-11
Register here: https://neurodynamicsolutions.com/products/chicago-schereville-lower-quarter-june-2026

LONDON, UK
October 10-11
Register here:
https://course.vitalpm.com/w/courses/23-lower-quarter-level-1-and-2-two-courses-in-one

FALKIRK, UK
November 7-8
Register here:
https://neurodynamicsolutions.com/products/falkirk-lower-quarter-course-november-2026

AND UPPER QUARTER
LONDON, UK
October 10-11
Register here:
https://neurodynamicsolutions.com/products/london-upper-quarter-course-nov-2026
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02/08/2026

💥💥💥LUMBAR NERVE ROOT - MULTI-DYSFUNCTION TREATMENT AND TWO LEVELS OF FUNCTION.
Technique Video

PATIENT IS PROVOKED WITH NEURAL MOBILISATION - Some patients have a small THERAPEUTIC WINDOW: their nerve root pain is provoked with gentle neural mobilisations but their back can move quite well. This is when the therapeutic window for the nerve root needs to be expanded so the nerves can tolerate treatment without provocation.

SOLUTION - here we can classify the interface at level 2 but the nerve root is at level 1.

OPEN THE THERAPEUTIC WINDOW - We can emphasise neural protection and rehab the interface at the same time, reducing provocation.

This is an example of the closing dysfunction at level 2 (rehab) and neural part at level 1 (pain relief).

TECHNIQUE - The lower side is painful and we gently close the foramen whilst UNLOADING the nerve root tension with the contralateral neural mobilisations.

27/07/2026

GASTROCNEMIUS AND TIBIAL NERVE - PALPATION FOR DETECTION.

The tibial nerve can become affected behind the knee, with possible several presentations:

1. Between the two heads of gastrocnemius and under soleus (soleal sling disorder).

2. Severe compression can produce weakness in plantarflexion and toe flexion, but this is not so common. It more often produces local pain with muscle actions and can be missed in muscle strains.

3. Large Baker’s cysts where compression and/or irritation can come from the swelling produced by the cyst.

4. Sciatica with multifactorial involvement.

TIBIAL NEURITIS OR NEUROPATHY should be considered in people with:
- sciatica
- knee injuries
- posterior knee pain and calf muscle strains, especially when recovery is taking longer than expected.

PALPATION is one way of several ways of finding the problem, particularly with soft tissue changes and sensitivity. Make sure you palpate next to the nerve on both sides to prevent a false positive.

There are several ways to palpate the tibial nerve and here is a common one.

We cover this on the new lower quarter (1+2) hybrid courses:
- 3 months online
- 2 days in-person.

Here are the next two Lower Quarter (1+2) courses:

USA, Chicago/Schereville, IN - October 10-11, 2026

UK, London - September 10-11

UK, Falkirk - November 7-8

LOWER QUARTER COURSES:
https://neurodynamicsolutions.com/collections/lower-quarter-courses

16/07/2026

COMMON PROBLEM IN NEURODYNAMICS

Neurodynamic Testing - ULNT1 Median.

On our courses, we cover all the common problems that produce incorrect results in neurodynamic testing, for the neurodynamic tests in the spine and upper and lower quarter.

The main failures rare:

- false positive.
- false negative - we will do this one.

--
FALSE NEGATIVE - Here is a common cause of a FALSE NEGATIVE with the Upper Limb Neurodynamic Test 1 (MNT1):

- a normal response when there is a neurodynamic problem.

THE NEURODYNAMIC TEST - is a collection of movements that serially apply force to the nerves to a point of response.

KEY RULE OF NEURODYNAMIC TESTING - A NEURODYNAMIC TEST IS ONLY AS GOOD AS THE WORST MOVEMENT.

The test fails to express itself accurately in the final movement (since they are all connected).

Here is the MOST COMMON ERROR that therapists make with the MNT1 - LOSS OF SHOULDER ABDUCTION DURING ELBOW EXTENSION.

Abduction to 110˚- Normally, we do abduction up to 110˚, hold it stable, then do elbow extension. But we often lose the abduction when we do the elbow.

Cadavers - We see in cadavers that a small loss of joint movement can produce profound changes in the tension along the nerve.

SO - IF YOU GO TO 110˚ ABDUCTION, THEN IT IS ONLY 90-100˚ AT THE END OF THE ELBOW EXTENSION - YOU HAVE LOST A KEY MOVEMENT AND MIGHT BE PRODUCING A FALSE NEGATIVE.

Here’s a short video about this point.

14/06/2026

HERE IS A GREAT SOLUTION TO DOING THE SLUMP TEST THE VERY TALL PATIENT.

Since it’s been basketball time, it's opportune to do something on a common clinical problem - the slump test in the VERY TALL PATIENT.

At Neurodynamic Solutions, we call it the ‘TALL SLUMP’.

Do you ever treat really tall patients? If you treat basketballers or volleyballers, THIS IS FOR YOU!

OR are you quite short and struggle to reach the patient’s feet while your other arm tries to control the neck?

THIS TECHNIQUE MODIFICATION HELPS!

PATIENT SELECTION:
• Tall patient.
• Short therapist (like me!).
• Low back pain and sciatica is the most common inclusion criterion.
• Patients with hamstring problems to test the sciatic tract.

TECHNIQUE:
The key is to ensure that all the key ingredients remain as close as possible to the original test:
• Contact points (C7 and head).
• Pressure - even all contact points.
• Spinal control - balanced weight on both buttocks.
• Same movements as the standard slump test.

HERE’S a video demo of the technique modifications to make it easier and more precise.

24/02/2026

💥💥💥 SLUMP TEST SURPRISE! Have you seen this during the slump test?

Here is a common situation on our lower quarter courses in the discussion and treatment sections.

Many of you out there do the slump test regularly because you likely see a lot of patients with LBP. But you can get surprised when this happens:

Trunk flexion - OK ✅
Neck flexion - provokes pain ❌
Knee extension - LESS PAIN 😀

🤷‍♂️

This does NOT MAKE SENSE if you are thinking of neural tension because the knee extension increases the tension - but the pain DECREASES!

What could this be?

This occurs all over the world and it likely represents a type of problem that affects the nerve root and/or dura specifically, related to the anatomy and location of a disc hernia.

Professor Stuart McGill talks about an “underhook” or “overhook” that may relate to the nerve root “axilla” or “shoulder” and where the nerve root is located in the canal or foramen - or how it moves.

NERVE ROOT MOVEMENT
- neck flexion moves the nerve roots UP ⬆️
- knee extension moves the nerve roots DOWN ⬇️
- doing both produces TENSION because they oppose each other ⬅️–➡️

BUT the pain may reduce with knee extension if the problem is an “overhook (shoulder) disc hernia because the knee extension moves the nerve roots downward ⬇️ and may reduce contact.

This often happens when you least expect it. I call it the Friday Afternoon Surprise, just when you don’t want them.

But it makes sense if we GO BEYOND NEURAL TENSION AND SENSITIVITY and think of nerve root MOVEMENT with specific diagnostic categories: tension or sliding (up or down).

Treatment depends on the dysfunction category.

WATCH THE VIDEO.

BEWARE - we also have this type of dysfunction in the upper quarter, particularly with the brachial plexus because it moves a lot and there is a very dynamic interface.

16/02/2026

🔥🔥🔥DID YOU KNOW? Applying neural tension in one area can DECREASE it in another.

1. MISCONCEPTION - A long-held misconception has been that applying tension along a nerve always increases tension in the connected nerves and nerve roots. This is sometimes incorrect because the nerve movements in other areas depend on the anatomy and biomechanics where angles and displacements change.

2. MECHANISM - As a nerve is tensioned distally, the nerve roots on the same side and spinal cord follow caudally. This cord movement can pass a reduction in tension to the nerve root on the other side.

3. NEURODYNAMIC RESPONSES - Neurodynamic test responses can reflect this reduction in tension. Knee extension during the slump test can reduce the neurodynamic response on the other side.

Reductions in neurodynamic responses:

- contralateral slump test - almost all subjects (Shacklock et al 2016, it was 100% but not likely when applied to larger population).
- bilateral leg raise - upper limb responses - 67% (Bell 1987).
- contralateral upper limb neurodynamic test - 62% (Rubenach 1984).

4. MPLICATIONS AND APPLICATIONS - Here are several uses for the mechanism:

a. b. c. Interpretation - bilateral techniques can be a lower progression than ipsilateral ones.

Diagnosis - contralateral nerve movements can be used to corroborate neurodynamic responses.

Treatment - techniques can be used to reduce tension for pain relief.

5. TECHNIQUE - How you do the technique is critical because small changes in technique can produce big changes in the result.

Video - here is an example of the bilateral straight leg raise.